Deck 25: Blood and Lymphatic Infections

Question 1

The sac which surrounds the heart is called the

A) endocardium.
B) pericardium.
C) atrium.
D) myocardium.
E) endothelium.

Answer 1

B

Question 2

The most common agent(s) causing infective endocarditis is/are

A) Streptococcus pyogenes.
B) Pseudomonas aeruginosa.
C) normal skin or mouth microbiota.
D) Escherichia coli.
E) normal gut microbiota.

Answer 2

C

Question 3

Blood and lymph may carry

A) antibodies.
B) complement.
C) lysozyme.
D) interferon.
E) All of the choices are correct.

Answer 3

E

Question 4

Which of the following is more likely to cause fatal septicemias?

A) Gram-positive bacteria
B) Gram-negative bacteria
C) Negatively stained bacteria
D) Acid-fast bacteria
E) Mycoplasmas

Question 5

The spleen, in part, functions to cleanse the

A) blood.
B) lymph.
C) interstitial fluid.
D) cytoplasm.
E) fluid.

Question 6

The small bean-shaped bodies into which the lymphatic vessels drain are the

A) lymph nodes.
B) adrenals.
C) subclavian veins.
D) valves.
E) lymph beans.

Question 7

Acute bacterial endocarditis differs from infective endocarditis in the

A) suddenness and severity of onset.
B) population affected.
C) resultant damage.
D) development of exotoxin shock.
E) causative organisms.

Question 8

High levels of antibodies in patients with infectious endocarditis cause inflammation because

A) they may form immune complexes that get trapped in skin and eyes.
B) the surface antigens change rapidly and become unrecognizable.
C) the antibodies initiate type I, type II, or type III hypersensitivities.
D) the antibodies degrade quickly and debris gets trapped in these organs.
E) they may form clots that lead to life-threatening emboli.

Question 9

A visible red streak in an infected hand or foot is referred to as

A) septicemia.
B) bacteremia.
C) lymphangitis.
D) edema.
E) plasmitis.

Question 10

The heart chamber that passes blood to the lungs is the

A) left ventricle.
B) right ventricle.
C) right atrium.
D) left atrium.
E) right ventricle AND left atrium.

Question 11

Which organism may be implicated in atherosclerosis?

A) Escherichia coli
B) Pseudomonas aeruginosa
C) Staphylococcus aureus
D) Chlamydophila pneumoniae
E) Mycoplasma pneumoniae

Question 12

The condition that develops on a previously damaged heart valve is called

A) an aneurysm.
B) acute bacterial endocarditis.
C) infective endocarditis.
D) myocarditis.
E) effective endocarditis.

Question 13

The material released from bacteria that may lead to shock and death in sepsis is

A) exotoxin.
B) protein A.
C) endotoxin.
D) interferon.
E) M protein.

Question 14

Although sepsis affects many organs, the organ(s) most seriously and irreversibly affected is/are the

A) heart.
B) lungs.
C) kidneys.
D) spleen.
E) pancreas.

Question 15

Which of the following is NOT a route by which bacteria that cause infective endocarditis may gain access to the bloodstream?

A) Trauma
B) Dental procedures
C) Brushing teeth
D) Ingestion
E) Kidney infection

Question 16

The scientist responsible for the development of the first anti-plague vaccine in 1866 was

A) Alexandre Yersin.
B) Robert Koch.
C) Louis Pasteur.
D) Josef Marburg.
E) Barbara McClintock.

Question 17

The circulation of an agent in the bloodstream is given a name ending in

A) -ase.
B) -ing.
C) -emia.
D) -ation.
E) -cyte.

Question 18

The fluid which bathes and nourishes the tissue cells is the

A) cytoplasm.
B) interstitial fluid.
C) lymph.
D) blood.
E) hyperstitial fluid.

Question 19

The plague bacillus is known as

A) Plasmodium vivax.
B) Pneumocystis carinii.
C) Streptococcus pyogenes.
D) Yersinia pestis.
E) Bacillus anthracis.

Question 20

The inflammatory effect of immune complexes lodged in the kidney is called

A) renal phritis.
B) glomerulonephritis.
C) rendema.
D) urethritis.
E) endophritis.

Question 21

The plague is typically transmitted via the bite of

A) ticks.
B) fleas.
C) lice.
D) mites.
E) mosquitoes.

Question 22

The development of lymph node enlargement in the region of a skin ulcer after a tick or insect bite or handling of a wild animal suggests

A) brucellosis.
B) endocarditis.
C) sepsis.
D) tularemia.
E) Lyme disease.

Question 23

Yersinia pestis typically contains

A) one plasmid.
B) two plasmids.
C) three plasmids.
D) four plasmids.
E) no plasmids.

Question 24

The common name for tularemia is

A) Bang's disease.
B) rabbit fever.
C) Hansen's disease.
D) Chagas' disease.
E) dog tick fever.

Question 25

Which of the following is/are able to survive phagocytosis?

A) Brucella species AND Staphylococcus aureus.
B) Staphylococcus aureus AND Francisella tularensis
C) Brucella species AND Francisella tularensis 
D) Francisella tularensis AND Staphylococcus epidermidis
E) All of these.

Question 26

The causative agent of plague is

A) Yersinia pestis.
B) Vibrio cholerae.
C) Staphylococcus aureus.
D) Brucella abortus.
E) Infected fleas.

Question 27

Traditionally, the animal(s) associated with hosting Brucella is/are

A) cattle.
B) dogs.
C) goats.
D) pigs.
E) All of the choices are correct.

Question 28

The virulence factor of Yersinia pestis that is a protease that destroys C3b and C5a is

A) Yops.
B) pla.
C) F1.
D) protein A.
E) V antigen.

Question 29

The disease responsible for the death of approximately 25% the population of Europe from 1346 to 1350 was

A) typhus.
B) pneumonia.
C) influenza.
D) plague.
E) endocarditis.

Question 30

Yops, proteins produced by Yersinia pestis,

A) interfere with phagocytosis.
B) activate plasminogen activator.
C) destroy C3b and C5a.
D) promote apoptosis.
E) control a type III secretion system.

Question 31

The production of heterophile antibody is associated with

A) tularemia.
B) brucellosis.
C) plague.
D) infectious mononucleosis.
E) sepsis.

Question 32

The major virulence factors of Yersinia pestis (capsule and Yops) are carried on

A) the chromosome.
B) a plasmid.
C) three separate plasmids.
D) the nuclear membrane.
E) the chromosome AND plasmids.

Question 33

Epstein-Barr virus may become latent in

A) red blood cells.
B) B cells.
C) T cells.
D) nerve cells.
E) macrophages.

Question 34

In order to culture the organism responsible for tularemia, the growth medium must contain

A) cysteine.
B) glucose.
C) charcoal.
D) NAD.
E) ATP.

Question 35

Symptoms of plague appear in

A) one to two years.
B) two to three months.
C) one to six days.
D) three to six hours.
E) three to six months.

Question 36

The cause of infectious mononucleosis is

A) varicella virus.
B) Staphylococcus aureus.
C) Epstein-Barr virus.
D) Francisella tularensis.
E) Yersinia pestis.

Question 37

Enlargement of lymph nodes or spleen is often associated with all of the following EXCEPT

A) tularemia.
B) brucellosis.
C) plague.
D) infectious mononucleosis.
E) vibriosis.

Question 38

The "Black Death" may also be known as

A) tularemia.
B) plague.
C) brucellosis.
D) endocarditis.
E) necrosis.

Question 39

Brucellosis may also be known as

A) Bang's disease OR rabbit fever.
B) Bang's disease OR undulant fever.
C) undulant fever OR Hansen's disease.
D) Hansen's disease OR rabbit fever.
E) rabbit fever OR undulant fever.

Question 40

Enlargement of lymph nodes or spleen is often associated with

A) tularemia AND plague.
B) brucellosis AND tularemia.
C) plague.
D) gastritis AND plague.
E) tularemia, brucellosis, AND plague.

Question 41

Why does it take more than a week before a mosquito that has just become infected with yellow fever virus can transmit the disease?

A) The virus must replicate in the gut of the mosquito before it can reach high enough numbers for transmission to a new human.
B) Mosquitoes only feed once a week, which limits their ability to transmit the disease rapidly.
C) Mosquitoes that acquire yellow fever virus become ill for a week thereafter. They have to recover before they can feed again and transmit the virus to the next host.
D) The virus multiplies in the gut of the mosquito, but then needs to migrate to the mouth of the insect in order to infect a new human being after a new bite. This migration takes time.
E) The mosquito actually transmits the virus almost immediately. It takes a week for the virus to multiply in the gut of the host before it causes any ill effects in that host.

Question 42

Sepsis is only caused by Gram-negative bacteria.

Question 43

How would crowded conditions in cities favor spread of bubonic plague?

A) Plague is transmitted by rats; more people means more waste, and more waste means more rats. This would favor the spread of plague.
B) Plague is transmitted by infected fleas; these fleas may be found on rodents (such as rats). More people in an area means a greater chance of interactions with animals carrying infected fleas, increasing the spread of plague.
C) Plague is transmitted by mosquitoes; more people close together gives an infected mosquito more chances to bite humans and transmit the causative agent, spreading plague.
D) Plague is transmitted by direct contact (e.g. skin to skin). More people in an area provides more chances for infected individuals to directly contact and infect other individuals, spreading plague.
E) Bubonic plague is transmitted by aerosol droplets. People in cities are always dependent on public transport, which is typically overcrowded, so are at risk of acquiring plague bacteria.

Question 44

Which of the following are transmitted by mosquitoes?

A) plague AND yellow fever.
B) yellow fever AND tularemia.
C) yellow fever AND malaria.
D) malaria AND tularemia.
E) tularemia AND plague.

Question 45

Both Francisella tularensis and Brucella melitensis are able to survive phagocytosis.

Question 46

Yellow fever is transmitted by

A) ticks.
B) fleas.
C) Aedes mosquitoes.
D) Anopheles mosquitoes.
E) lice.

Question 47

Muscles aid the flow of venous blood.

Question 48

Yellow fever is caused by a protozoan infection.

Question 49

The disease caused by an enveloped single-stranded RNA arbovirus of the flavivirus family is

A) brucellosis.
B) yellow fever.
C) malaria.
D) herpes.
E) chikungunya.

Question 50

The genes for the capsule and Yops of Yersinia pestis are carried on a plasmid.

Question 51

Gram-positive organisms are more likely than other infectious agents to cause fatal sepsis.

Question 52

The spleen enlarges in 

A) infectious mononucleosis AND Lyme disease.
B) malaria AND Lyme disease.
C) brucellosis AND sepsis.
D) infectious mononucleosis AND malaria.
E) plague AND sepsis.

Question 53

Which species of Plasmodium causes the most serious form of malaria?

A) falciparum
B) ovale
C) malariae
D) vivax
E) knowlesi

Question 54

The media used to successfully grow Francisella tularensis must contain cysteine.

Question 55

Plasmodium falciparum causes the most serious form of malaria.

Question 56

Which of the following may be transmitted by saliva?

A) Infectious mononucleosis
B) Dengue fever
C) Plague
D) Yellow fever
E) Chikungunya

Question 57

What is the difference between "bacteremia" and "sepsis"?

A) Bacteremia is an infection with bacteria. Sepsis is an infection with Septic protozoans.
B) Bacteremia is the presence of living, multiplying bacteria in the bloodstream. Sepsis is the presence of endotoxins, but not necessarily of living microbial agents.
C) Sepsis is the presence of living, multiplying bacteria in the bloodstream. Bacteremia is the presence of endotoxins, but not necessarily of living microbial agents.
D) Bacteremia is a serious infection that is almost always fatal. Sepsis is less serious and can usually be treated with broad spectrum antibiotics.
E) There is no difference; both terms indicate the presence of living bacterial cells in the bloodstream.

Question 58

Both malaria and yellow fever are transmitted by mosquitoes.

Question 59

In a malarial infection, only sporozoites can infect the human liver.

Question 60

Which of the following is caused by a protozoan?

A) Malaria
B) Yellow fever
C) Tularemia
D) Infectious mononucleosis
E) Dengue fever

Question 61

The preferred host of Ixodes scapularis is the

A) wood rat.
B) white-footed mouse.
C) moose.
D) human.
E) ground squirrel.

Question 62

The stage of Lyme disease that is characterized by arthritis is the

A) primary.
B) third.
C) second.
D) fourth.
E) intermediate.

Question 63

Which statement about the cardiovascular and lymphatic systems is NOT True?

A) The cardiovascular and lymphatic systems are typically sterile.
B) Veins carry blood away from the heart while arteries carry blood towards the heart.
C) Inflammation of lymphatic vessels is called lymphangitis, which presents as a red streak from an infection site toward the nearest lymph node.
D) Blood is exposed to immune cells as it passes through the spleen.
E) Phagocytes in spleen red pulp remove aging or damaged RBCs, bacteria, and other antigens from the blood.

Question 64

What leads to organ failure in sepsis?

A) Uncontrolled inflammation that leads to neutrohpils releasing damaging toxins and lysosomal enzymes.
B) Helper T cells and dendritic cells undergo apoptosis, causing immunosuppression that results in organ rejection.
C) Formation of small clots in capillaries, impairing blood flow to organs and causing hypoxia and cell death.
D) Accumulation of endotoxins released from Gram-negative bacteria in the organs, causing tissue damage and cell death.
E) Organisms from an infected site generate biofilms that break apart, leading to emboli and organ destruction.

Question 65

When Lyme disease was first being investigated, the observation that frequently only one person in a household was infected was a clue leading to the discovery that the disease was transmitted by arthropod bites. Why was this so?

A) If the infection is spread by the bite of an arthropod, it wouldn't spread easily by respiratory secretions, direct contact, or sexual contact between individuals within the family.
B) Mosquitoes (an example of arthropods) are never inside a house. They are strictly outdoor insects, so they couldn't spread the infection inside the household.
C) Mosquitoes (an example of arthropods) only bite once in their lifetime. As such, they can only transmit the illness once before they die. Even if an infected mosquito was inside a house, it could only infect one human.
D) Arthropods lose their mechanical ability to bite a human after a single bite, much like certain bees lose their stinger after a single sting. This prevents them from transmitting the infection to more than one individual in a household.
E) These are all valid reasons that support the theory that Lyme disease must be transmitted by arthropod bites.

Question 66

Borrelia burgdorferi is a microaerophilic spirochete.

Question 67

Select one False statement about sepsis.

A) Lung damage is an important cause of death in people with sepsis.
B) Sepsis can be caused by Gram-positive or Gram-negative bacteria.
C) Common causes of fatal sepsis include members of the normal microbiota of the large intestine.
D) Sepsis is sometimes a healthcare-associated illness but is more commonly a community-acquired infection.
E) Use of medical equipment where biofilms readily develop increases the risk of sepsis.

Question 68

Which of the following pertains to Borrelia burgdorferi?

A) Coccus
B) Bacillus
C) Spirochete
D) Filament
E) Capsid

Question 69

What causes the characteristic erythema migrans of Lyme disease?

A) After a person acquires the causative bacteria by eating contaminated meat, the bacteria migrate to the skin in a corkscrew-like motion, killing host cells as they move and causing the bull's-eye rash.
B) After being introduced into the skin by the bite of an infected tick, the Gram-negative bacteria migrate outward in a circular manner; the LPS in their outer layer causes an inflammatory reaction.
C) After being introduced into the skin by the bite of an infected mosquito, the Gram-positive bacteria migrate outward in a corkscrew-like manner; the NAGs and NAMs in their cell wall causes an inflammatory reaction.
D) Borrelia bergdorferi cells propel themselves from host cell to host cell using actin tails, in a manner similar to Shigella cells. As they move, the bacteria destroy the host cells, causing the characteristic rash.
E) Borrelia bergdorferi is an encapsulated organism. The capsule of these cells is composed of hyaluronic acid that causes a widespread inflammatory response in the skin of the host that manifests as a rash.

Question 70

Select the statement about plague that is True.

A) When Yersinia pestis infects the lungs, septicemic plague always develops.
B) Bubonic plague is transmitted by the bite of infected mosquitoes that have also bitten rats.
C) The causative agent of plague is a facultatively anaerobic, Gram-positive rod.
D) DIC causes the dusky color of skin and mucous membranes characteristic of bubonic plague.
E) Bubonic plague is almost always fatal.

Question 71

The unique characteristic of Lyme disease is

A) erythema migrans.
B) induration.
C) carbuncle.
D) furuncle.
E) rash on palms.

Question 72

Why is it more difficult to treat a late persistent Lyme infection than an early disseminated Lyme infection?

A) The bacteria have developed resistance to multiple antibiotics by the late stage of the disease, so it is difficult to effectively treat a person.
B) A person with Lyme disease develops resistance to multiple antibiotics throughout the course of the disease, so treating them in the late stage of the disease becomes challenging.
C) Borrelia bergdorferi produces extremely resistant endospores in the late stage of the disease. Once these have been formed, it is very difficult to treat the disease.
D) The bacteria are no longer dividing in the late stage of Lyme disease, and as antibiotics only work against actively dividing bacteria, they are less effective at this stage.
E) Borrelia bergdorferi forms dense biofilms under the skin of infected people in the late stage of the disease. Bacteria within biofilms are protected from the effects of antibiotics and are difficult to kill.

Question 73

In infective endocarditis, septic emboli may break off. What is/are the possible outcome(s) of emboli in the circulation?

A) They may block blood vessels, leading to death of the tissue supplied by the vessel.
B) They can cause a vessel to weaken and balloon out, forming an aneurysm.
C) They lead to the formation of immune complexes that lodge in the skin, the eyes, and other body structures.
D) They can cause a vessel to weaken and balloon out, forming an aneurysm AND they may block blood vessels, leading to death of the tissue supplied by the vessel.
E) They lead to the formation of immune complexes that lodge in the skin, the eyes, and other body structures AND they can cause a vessel to weaken and balloon out, forming an aneurysm.

Question 74

Which of the following contribute(s) to lung damage in people with sepsis?

A) Increased capillary leakage of plasma AND damaging lysosomal enzymes released from leukocytes.
B) Damaging lysosomal enzymes released from leukocytes AND organ damage from clots in capillaries.
C) Depletion of clotting proteins AND decreased muscle tone of heart and arteries.
D) Depletion of clotting proteins AND damaging lysosomal enzymes released from leukocytes.
E) Decreased muscle tone of heart and arteries AND increased capillary leakage of plasma.

Question 75

The most important vector of Lyme disease in the eastern United States is

A) Dermacentor virabilis.
B) Dermacentor andersoni.
C) Staphylococcus aureus.
D) Ixodes scapularis.
E) Borrelia bergdorferi.

Question 76

Which of the following virulence factors of Yersinia pestis aid(s) in attachment to host cells?

A) Yersinia outer proteins (Yops)
B) Endotoxin
C) PsaA
D) Pla
E) V antigen

Question 77

What is unusual about Borrelia bergdorferi, the causative agent of Lyme disease?

A) Borrelia bergdorferi is a pathogenic spirochete.
B) The bacterium is a Gram-negative, microaerophilic pathogen.
C) The organism contains plasmids that have genes normally found on the chromosome.
D) B. bergdorferi causes flu-like signs and symptoms when it first infects a host.
E) The cells have a thin peptidoglycan cell wall with an outer membrane containing LPS.

Question 78

The growth stage of the vector that is mainly responsible for transmitting Lyme disease is the

A) nymph stage.
B) egg.
C) moulter.
D) adult.
E) mouse.

Question 79

Lyme disease is a zoonosis with humans being an accidental host. What does this mean?

A) Borrelia bergdorferi is transmitted to animals from humans AND the bacterium cannot complete its life cycle in humans.
B) Borrelia bergdorferi is found predominantly in zoo animals AND the bacterium cannot complete its life cycle in humans.
C) Borrelia bergdorferi is transmitted to humans from animals AND humans are not the normal host for the tick vector.
D) Borrelia bergdorferi is found predominantly in zoo animals AND the tick vector cannot complete its life cycle in humans.
E) Borrelia bergdorferi is found predominantly in zoo animals AND humans are not the normal host for the tick vector.

Question 80

Which statement is NOT True of Lyme disease?

A) Untreated Lyme disease can lead to serious complications, including arthritis and cardiovascular and neurological problems.
B) The main reservoirs for Borrelia bergdorferi are infected white-footed mice, deer, deer ticks, and deer mosquitoes.
C) Several different antibiotics can be used to treat patients in the early stages of Lyme disease, including doxycycline, amoxicillin, and cefuroxime.
D) Chronic Lyme disease signs and symptoms such as arthritis occur due to persisting bacteria and the host's immune response to them.
E) Signs and symptoms of Lyme disease occur in three phases, although individual patients may be asymptomatic in one or more of these stages.